Mind Is Not a Vessel to Be Filled, but a Fire to Be Kindled Essay

â€Å"Education† may be an ordinary word to most people, but very few actually understand the deep meaning beneath it. In this dynamic world, we need to be equipped with the necessary skills and hard work to survive. Understanding the education system is integral to allow students to understand the purpose of studying, the purpose of going to school everyday. Is education in Singapore really â€Å"holistic†? Are there flaws? What is education? By definition, it would be something along the line of â€Å" transferring knowledge†. I beg to differ. In my opinion, education consists of more than just knowledge. From Kindergarden to University, students are put through the daily routine of waking up early in the morning, going to a place where teachers teach â€Å"the same old stuff†. By that, I am referring to knowledge. Knowledge is power, you might say. Indeed, being knowledgeable helps you stand out among the rest during the tests and examinations. But is that all about education ? Acing the tests and getting a degree? I’m afraid no. Years after years, Singapore universities and institutions are well-known on the global front for being able to produce students with top grades. These results just keep getting better and better. Foreigners come to Singapore for education. Most people might therefore think education in Singapore is perfect. I also acknowledge that these are true, but only to a certain extent. On the other spectrum ( which is usually not shown), there are students who are not performing as well as their peers, students who are doing well but facing a lot of unnecessary stress. This is prevalent as well. The obsessive reliance of tuition to produce grades, online forums to discuss ways to â€Å"headstart my child in education†. I find no meaning in these. This is passive learning. Similarly, there are exceptional cases which bring out the ugly truth about education in Singapore. Students faking degrees to earn scholarships, jobs , graduates saying vulgarities during graduation ceremony to ‘rejoice’ over the achievements, even local scholar prosecuted overseas for doing unethical things such as watching child pornography. If education in Singapore is so perfect, why would such disgraceful incidents occur? Let us look at some possible reasons. Memorizing dictionaries, memorizing textbooks, doing thousands of assessment books, attending endless tuitions and supplementary classes†¦ These are some things most pupils in Singapore are going through. They have my sympathy. Everything I have described until now is about passive learning, which revolves around results and lacking in true meaning of education. Now, let us zoom into another aspect. Imagine this : a child who does his work consistently, revises on daily basis, reads newspapers everyday. Everything without being told. Seems like a utopian child? No. It is possible. The only thing he has compared to other students is the passion. The burning passion inside him to learn, to absorb knowledge. This drive pushes him to do everything on his own. There is no tuition, no supplementary classes, reasonable number of assessment books. Yet, this child is scoring ‘A’s for his subjects. In Singapore schools, Ministry of Education is encouraging a whole new approach towards â€Å"holistic† education. Co-curricular activities, Community Involvement Program, Civics & Morals Education†¦ these are programmes put in place after much effortful planning of the education ministries. There are even more recent policies such as not revealing top students for national examinations such as Primary School Leaving Examinations. I respect them for that. However, there are rooms for improvement. CCA, short for co-curricular activities, is a word that is often hung in the pupils’ mouth. Whether they say it out of pride in a good way or bad way, I do not know. This brings me to the point of CCA mismatch. Students who feel they are â€Å"not good enough† for a CCA only after a few years in that CCA, students who feel indignant as they feel they could have gotten into â€Å"better CCA†. What are the consequences of this? Students not attending CCAs regularly, students complaining about how ‘ sien ‘ ( boring and uninteresting) their CCA is. This leads to stereotyping about CCAs and split between different CCAs, especially Sports vs Non-Sports. While you might say it is good that CCAs are bonded together as a team, the purpose of bonding is wrong. They are making fun of other people and things they do. In the long run, this will not work. Another thing is when pupils do not attend CCAs, the school has no choice but to use deterrence methods such as demerit points. To tackle this whole situation, there is Direct- School- Admission put in place to reduce scenarios like this however the success is limited. After talking about limitations of the current education system put in place, I have some suggestions. What I will say is also something simple : passion. Again, a simple word yet deep meaning behind it. If a student is an active learner, problems such as late/no submission of work, lack of focus during lessons, loss of notes, game/social networking addiction etc will all be eliminated at once. Students will not complain ‘ Life is Tough’ or ‘ There is too much work yet too little time’ etc. Teachers no longer have to chase after the students for work, give students boring supplementary classes. Teachers no longer have to scold students, which deviates their focus on teaching that will result in drop in productivity. This will lead to more supplementary/remedial classes which make students get tired of learning. Ultimately, they lose passion in learning. This evil cycle of mad chase, forced homework, drilled practice will keep on going until the students change their attitude. If the students take charge of their own learning, they will automatically focus during lessons and give constructive feedback that can engage the whole class in a positive manner. This will accelerate learning so much that the teachers will be more willing to teach and even plan fun activities for pupils to play and learn at the same time. At the same time, the students will strive to do their best in everything including daily worksheet, assignments. Ultimately, success ( which is good grades people chase after) will follow them. Therefore, I strongly feel that passion is much more important than knowledge. To put this passion in them, I think teachers, parents and students themselves all play a crucial role to ‘kindle the fire’ within them. They can help create encouraging environment to allow pupils to share their opinions on certain topics and letting them think ‘out of the box’. They can reduce things such elitism stereotyping to encourage the pupils to exchange feedback healthily and letting them learn from one another. Occasionally, having useful motivation courses in schools by professionals also might help. Once this fire is lit, the action will follow. Students will start finding joy in learning and unknowingly, they will get good grades without even getting stressed or tired.

On Pathography

Why do humans write them? Robert Maunder, a physicists and professor, illustrates an essay called, â€Å"On Photography,† that presents meta-commentary stories In Body & Soul. The genre of literature called, â€Å"photography,† describes his essay and Interest about being sick. Maunder establishes terms such as battle, triumph and survivor to reflect on the narratives of Illness. He describes his essay through elements of critical thinking by clarity, evidence of support and assumptions underlying the argument. As a result, Robert Maunder clearly manifest his main proposal successfully.Maunder expresses the clarity of his main argument of photography through his beliefs. For several of patients, to triumph over sickness, signifies an important part of the experience. The best photographers, in Maunders eyes, are those â€Å"like the best novels and poems, {he} suppose, describe life with subtlety contradiction, emotion, depth, beauty and banality. But it helps to read the best† (Maunder, 2004). Sometimes, the most efficient teaching lad Is to analyze and read written accounts of one's aspect from sickness or facing death as It can receive empathy towards one another.Patients who are diagnosed with a terminal Illness can evoke fear, depression and anger. However, Maunder also believes that the best photographers are those â€Å"who are curious and unashamed enough to write about what illness has done to their minds and preferences and relationships† (Maunder, 2004). It indicates that the existential truth is a familiar Indus of reflection for a sick writer, which the author compares to personal victory. The capability of understanding and connecting tit one and another is faint. Maunder argues how â€Å"a critically ill person needs above all is to be understood.Dying is a misunderstanding that you have to get straightened out before you go† (Maunder, 2004). Sickness cannot be acknowledged for understanding, until your friends and family, with love, recognize the absolute knowledge of your chronic disease. Thus, the clarity of his main argument Is pushed by his beliefs. He contributes his mall argument through personal observations, reflection, and anecdotes, as he not only try to convince the reader, but also himself. Maunder uses personal observation with his patients and students by reading photographers of other authors.He begins with Robert Mason Lee's photography, of his pain of Chronic disease, where his audience was conveyed by â€Å"the experience of that particular pain very well to someone who has never felt it. † (Maunder, 2004). He explains how a powerful writer has the unique ability to express their connections to feelings and awaken our senses. These senses are within others and us, where it results to think in synthesizing ways. Maunder also uses personal, short and amusing vents to account his message across.For example, he has read â€Å"few other essays where the author Is so c ompletely alive and present In the text, in all his narcissistic, gleeful, annoying, contemplative splendor,† such as Anatoly Broad (Maunder, 2004). Board's wrote a photography called, â€Å"Intoxicated by My Illness,† as he was dying of prostate cancer. This photography captivated Maunder eye's due to his bright and insightful personality, where did not take sickness as a serious event, but by convinced that â€Å"illness is a test of relationship, of values, and of faith-but as Job caches us, it is a test that, once passed, continues nonetheless† (Maunder, 2004).Illness and life are similar. However, illness can render as the greatest destroyer of denial where it has the power to reach a person's soul negatively. These personal experiences assist Maunders main argument. Maunder also apply his assumptions to propel his argument forward. He postulates how humans view their morality is recognized. He believes how â€Å"the battle metaphor of destruction is not ap propriate in this instance either. What serious illness does to denial is make it obvious† (Maunder, 004).Young children, teenagers and adults, are almost always solipsistic, that it affects their worldview. A sickness is Just to overcome, whereas older people, it becomes more of a challenge because they dwell on it, which can consume them. As a result, it changes their mindsets for the worst. Maunder continues his assumptions for how the society views on morality by providing the idea that one can truly live when they are faced with a death crisis. He brings â€Å"another version of the hope for redemption through illness† (Maunder, 2004).Maunder imagines his hopes for others who have suffered through illnesses, where it might illuminate certain situations and help gain perspective. For a while, Maunder takes a step back from writing illness narratives and explores into the genre of literature, consisting of stories regarding the aspects of sick patients. He argues tha t â€Å"triumphant battles, how much they actually do convey an important part of the experience of being sick for many people,† is an expectation (Maunder, 2004). Humans, who struggle with chronic illness(s), are the toughest of the tough.They are able to continually face the struggles of life and battle a debilitating disease than those who appear to live with it. Consequently, Maunder takes granted for people who lack of the knowledge of being sick to drive his topic ahead. In summary, Robert Maunder proves his main idea thoroughly and distinctly. He uses clarity, evidence for support and assumptions to underlie the principle of the argument. Maunder narrates photographers about being sick and communicates an extraordinary manner to an incomprehensible audience who Just needs to understand.

Final environmental ethics Research Paper Example | Topics and Well Written Essays - 3750 words

Final environmental ethics - Research Paper Example In regards to this, ecology plays an important role in helping to understand the responsibility of human beings towards one another and the environment. In addition, it helps understand why these responsibilities are existent. There are a number of ecological disciplines that assist in achieving the goal of understanding the moral obligations of human beings. This paper will discuss the debate raised by Leopold’s suggestion: that the role and view of man should change from an anthropocentric one to – to one that allows hem to accord the natural world intrinsic ethical value. The paper will discuss the nature that man should play like a warden of the natural-world community, but not the conqueror, who can exploit the natural world for the selfish interests (Leopold, 1960, p. 220). Discussion Many scholars argue that human beings have a moral standing – which is superior to that of the natural world, including animals and the natural phenomena. However, the minimal extension of the moral nature of humans to cover the natural world causes real and difficult problems. These scholars, including Aldo Leopold hold that such an anthropocentric ethics base fails to go a long way, in offering the regard and the protection to be offered by the different natural community members. Therefore, they have offered and carried out studies, geared at the expansion of moral standing, to reach beyond the human community. Under this perspective, they claim that the selfish benefits of human beings can be addressed or eliminated through advocating, thus realization of better regard and treatment for the natural environment. In this regard, Radical ecology views moral standing as insufficient to resolve the environmental threats facing the natural balance to be attained. Radical ecologists argue that contrary to the shallow approach by moral standing, a wider philosophical perspective should be adapted, where human beings will shift their attitude towards the envi ronment as well as their understanding of reality of the balance between the different community members. In a bid to achieve this, it is necessary that human beings re- examine their place, so as to be able to comprehend the place they take and how they identify with the rest of the natural world, which is often abused, through uncontrolled abuse of the natural world. The utilitarian tradition of environmental ethics, on the other hand, holds that the maximum good and for the greatest number should be the goal, in defining the value and the importance to be given to the parts of the natural environment. The model, particularly points out two types of good to be considered, including the good which is held to be good for its own sake and the good which is good, because; it promotes other areas of good. Towards attaining this, preferences under watch are compared, where the preferences of different people or groups are conflicting. One of the major strengths of this model is that it is embedded in ordinary ways of reasoning and thinking (Des Jardins, 2001, p. 30-32; Abbey, 2002). These views are relatively divergent to those of deep ecology, which works on the basis of the basic principle that the living environment as a whole has similar rights to live and flourish. The endowment of rights to live and flourish, according to the model, is grounded upon the reality of man’s relationship with the natural environment and that between these different parts of the natu

The Politics of Education Assignment Example | Topics and Well Written Essays - 750 words

The Politics of Education - Assignment Example of education with successful establishment of libraries in some societies, Mann claims that education contributes immensely towards individual’s mental improvement (Massachusetts. Board of Education 95). He relates most countries’ prosperity with education; he believes that education contributes to growth and development of a successful generation. Additionally, Mann believes that education has a significant impact on how governments bestow their leaderships; he believes that education enhances the discharge of regal duties by the government. Mann’s views on education conquer with the current perception of education. This is evidenced by how majority f the people value education in the current societies; most people believe that education gives individuals the platform of expressing themselves. It also boosts the courage of people who value their rights; it enables them question their leaders about the mistakes they make in their daily activities. It is also evident that lots of advancement has taken place in the current societies because of increase in the rate of literacy among people. Additionally, most people are successive and independent today because of exposure and awareness enhanced by education. In what ways were you prepared by your experiences in elementary, middle, and high school for achieving success in college? In what ways did the readings help you understand better how you were educated? The passage of my lifetime through elementary, middle, and high school played a very significant role in my life. It made me value books and develop the urge of advancing my education elsewhere after high school. It is through the association with my colleagues in these academic levels that I garnered courage that enabled me to associate with other students from different backgrounds. Apart from learning that hardworking plays a pivotal role in one’s academic success, my passage through high school also made me have easy time in college; the experience

The black cat by E. Poe Essay Example | Topics and Well Written Essays - 500 words

The black cat by E. Poe - Essay Example Virginia served as a pattern and embodiment of love in Poe’s several novels such as Annabel Lee, The Raven, and Ligeia. Poes one-time employer George Rex Graham said about their relationship: "His love for his wife was a sort of rapturous worship of the spirit of beauty." I believe that his devotional love in inherent in a good marriage. After her death, he tried to have a comfortable life with a poet, Sarah Helen Whitman. However, their relationship ended, because of Poe’s serious alcoholism. Such behavior was a result of the sorrow he felt after Virginia’s death. Edgar Allan Poe was one of the representatives of Gothic literature. Gothic art was predominant in the Romantic era, thus Poe’s writings were affected by Romanticism. Romanticism was an artistic, literary, and intellectual movement that praised imagination over reason, emotions over logic, and intuition over science-making way. It rejected the rational and intellectual, and Allan Poe emphasized that didactic and intellectual elements were absent in his work. The Black Cat is an example of Gothic literature work. The black cat’s time and setting is obscure and vague, and it creates an uncanny atmosphere. The beginning of this story is ordinary and friendly, and narrator’s childhood sounds loving. However, happy introduction foreshadows the horrendous ending in Gothic literature. Moreover, there are many Gothic images in the novel. For example, cat’s figure imprinted on the wall brings grotesque illusion. Disturbing vision of cat to the protagonist is akind of foreshadowing of coming event. He tries to ignore superstition and offer a reasonable and scientific explanation. As the narrators extreme hatred and rage to the cat cannot be explained logically, I suppose that cat is a supernatural object, and symbolizes his tortured conscience. Humanity’s fear and fascination is unknown in Gothic literature. Narrator in The Black Cat commits

NPOs Are Best Equipped To Deal with Environmental Problems Essay

NPOs Are Best Equipped To Deal with Environmental Problems - Essay Example This essay stresses that NGOs are a natural product of democracy and capitalism. The argument is that as market forces need increasing moderations of the law for their benefit, society naturally calls for social justice to equalize negative factors of market forces. One way is through environmental NGOs, whose operations are based on this relationship between market forces and environmental pollution. Considering the costs to offer better environmental quality are high, it is logical for ENGOs to decide not to deal with them directly. This report makes a conclusion that NPOs are the most trusted and credible source for advocacy against environmental degradation and its conservation. Environmental support entails petitioning states explicitly or implicitly to cause change in conduct that could assist the extrication or prevention of environmental crises. Outside interventions like conventions, authorizations, economic incentives, and national mediations like ethical suasion might spark these desired changes. Instances of high net expenses to the actor assuming the change as a duty, outside motivators can help lower these expenses. In such instances, a policy of ethical suasion assists the change of particular value systems and preferences, which is important in assuring any behavior change. ENGOs might enjoy greater reliability by states in advocating environmental conservation and spreading of information about environmental challenges, NPOs are credible amongst the people.

Marketing Mix for U.S.A car market Chery Cars China Essay - 8

Marketing Mix for U.S.A car market Chery Cars China - Essay Example The study outlines the various approaches that can be incorporated in the marketing mix strategy so that the company can gain maximum profit from the international markets. The marketing mix is a very effective tool that helps the company to set the plans to promote its product into global markets. This study helps to highlight the different aspects of the marketing mix strategy and even comprise of certain recommendations that would facilitate the operations of Chery in the USA market. Chery automobile was founded in the year 1997 and it has rapidly grown into one of the biggest car makers in China. The company currently manufactures 15 models of minivans, commercial vehicles and the passenger cars. Its product line even includes the V5 crossover and A5 sedan. The company sells the products under the brand names of Tiggo, Chery and Eastar. The statistical report about the company states that the company sells approximately 800,000 vehicles in a year. The culture of the USA market is such that it provides opportunities for many car makers. The consumer market of USA is very brand conscious and possessing a car is one of their basic needs. In this market cars are often regarded as a status symbol. This eventually leads for more of scope for car manufacturers to expand their operations in the USA market (Abell, 2010, p. 43). The marketing mix is defined as a set of actions or tactics that the company undertakes so as to promote its product or brand in a desired market. The marketing mix is described by the 4Ps which comprises of Product, Price, Place and Promotion. However there exist other 3Ps also such as People, Process and Physical Evidence (Steers, 2006, pp. 77-78). There are two kinds of marketing environment – micro and macro. The micro marketing environment comprises of all the factors that are related to the company and have a direct impact of the company’s ability to serve its customers, such as suppliers, marketing intermediaries,

Identify the primary theories that guide your intergrated theoretical Essay

Identify the primary theories that guide your intergrated theoretical perspective of social work practice - Essay Example A boundary line such as a line, a plane or a point, implies or secures a limit, a periphery, a range, or a barrier. To span â€Å"is to form an arch over, to extend over across† (Kerson, 2002, 1); thus, a boundary-exceeding framework to health-related social work broadens over already penciled in barriers so as to provide social workers a greater range of perceptiveness, greater autonomy in interventions, and greater access to organizations and structures. This paper then will discuss the importance of boundary-exceeding in all areas of social work so that social workers can learn to assist their patients, clients and consumers to achieve their aspirations (ibid). Throughout its years of experience, social work practice in mental health has revised itself by or has been described by several boundaries. Occasionally, the borders have been created for the participants; some times, the restrictions have been designed by the participants themselves. Such limitations have occasionally got in the way of social workers’ capability to comprehend or resolve in the most practical means. Throughout time, even if social workers have drawn the parameters themselves, they have discovered the boundaries too limiting (Meyer, 1988). In response, social workers have had to locate ways to batter down the hindrances, to do the practice tantamount to finding tougher or wider scopes, opening entryways, breaking down walls, or insisting for greater autonomy. This ecological reinterpretation caters to and redefines various existing parameters or boundaries, and this reinterpretation claims that parameters have to be spanned in manners that are less preventing (ibid). The first parameter that should be spanned is the thing that detaches health care from mental health care. Fresh knowledge on the symptomatology, etiology and handling of an array of

BSC Flexibility & the Customer Perspective Essay

BSC Flexibility & the Customer Perspective - Essay Example David P. Norton and Dr. Robert S. Kaplan pioneered the approach in the 1990s. The case study is from the British Airport Authority (BAA) at Heathrow Airport’s Terminal 5 project. They termed their balanced scorecard as the T5 BSC. T5 was a performance management system based on key performance indicators and measures. This paper also compares the Norton’s BSC approach to the T5 BSC approach. T5 BSC based on 5 key performance indicators, 10 key measures, and 37 performance data. The performance indicators were selected as high-level quality indicators to drive the project’s objectives & requirements, identify the stakeholders, agreement of benchmarks, performance of inspections and test from the begin to the completion of the project. The indicators related tot the key measures gave general directions of the project through enablers, monitoring progress, or ascertaining outcomes. The performance data were the metrics that were measured for each stage of the projec t. Team members did this in order to monitor performance. The key measures would be regularly reported and published (Basu, Little & Millard, 2009). The main objective of any measurement system should to encourage managers and other employees to work towards implementing the organization’s strategies. Through the translation of strategy into measure of the balanced scorecard, all parties can know objectives and goals. ... roject, key performance indicators and key measures of the project were made to meet the requirements of the T5 Agreement and its complexity, spanning road, rail, and air constructions. The T5 balanced scorecard has incorporated the balancing principles of Norton’s balanced scorecard fours aspects i.e. learning & growth, customer, internal processes and financial. In the T5 BSC, the leading indicators are given by the benchmarks agreed & the verifications planned and work supervised. On the other, in Norton’s BSC, the leading indicators are given by learning & growth aspect. Considering the outcome indicators, the handover agreed and work complete in T5 can be related to the customer aspect in Norton & Kaplan BSC. Norton and Kaplan’s BSC aspect of internal process can be related to T5’s inspected and protected, and compliance assured measurement indicators. On further analysis, not all the measures as groups in each of T5 indicators act according to Kaplan and Norton’s BSC aspects. For example, the financial aspect relates to the total estimated cost of NCRs, a key measure of the compliance assured performance indicator. It can also be argued that the T5 KPIs and key measures have gaps related to the growth and financial BSC aspects but the assembly and manufacturing level performance indicators would not be expected to counter this. Kaplan and Norton’s Balanced Scorecard Aspects T5 Balanced Scorecard Customer Handovers confirmed RFT Closed outstanding work items Confirmed O&M manuals Confirmed Maintenance work plans Learning & growth Agreed test & inspection plans agreed Supervisors RFT-trained Financial Set Samples/benchmarks Total estimated cost of NCRs Internal processes Inspections with respect to the set benchmark & quality standards Checks confirming

Tudor goverments Essay Example for Free

Tudor goverments Essay What caused Tudor poverty and what did Tudor goverments do to reduce the number of the poor In Tudor England at the time of Edward V1 there was a huge diffrerence between the lives of poor people and the rich. There were many reasons for this. The lords were changing from growing wheat to farming sheep. Needing fewer men for work. Henry V111 had closed down all the monestries and the monks had no jobs. Also the poor people who relied the monks to feed them couldnt get food from the monestries any more. A lot of the lords had had private armies. The Tudors wanted to make the lords weak and made them pay lots of money to the king so they couldnt have huge armies and that meant to alot of soilders were unemployed. Many people who had not got jobs had to go round the country begging and robbing as there was no social sucurity like we have. The poverty was a big problem for Henry V111 who was Edward V1s father Henry divided the poor into deserving and undeserving. People who Henry felt couldnt help being poor he helped. This included giving them license to beg. If they were caught begging and they didnhave a license they would be whipped. This would leave great scars, so if they if they were caught again they would have the lobe of thier ear cut off, and the ear doesnt grow back so if they were caught they would be hung. In Edward V1s time the vagabonds would be branded on the tongue. These punishments didnt do anything to help the poor. In Elizabeths time minsters tried various ways, like the House of Correction, which was a bit like a prison in our days. This took some of the poor of the streets. We know the reasons why people became poor but the King or Queen didnt know. If they knew the real causes they might of done things to prevent poverty. In Elizabeths reign things got a bit better for some. For example a man called Robert Wheller who gave his attic to the poor and gave them two shirts,waistcoats a hankerchief each and free food. But most people were stiil poor and they had to beg People tried to get licenses to beg by pretending to be the deserving poor. They put soapy water into their mouths and it would look like they had epilepsy. Some poor people were tricked into joining the army.Agents from the army would put a coin into a persons drink and when it touched their lips they would have to join the army. This at least stopped the poor being beggers. I would not like being a begger in those days because the poor couldnt afford to have a doctor and many were disabled. There was no one to turn to for help and you wouldnt of lived for very long. Other poor people might of attacked you. At the beginning of the Tudor time the goverment just punished you for being poor. Things got a bit better when people like Robert Wheller helped the poor.

Beta Blockers Properties Of Propranolol And Atenolol Biology Essay

Beta Blockers Properties Of Propranolol And Atenolol Biology Essay Abstract This essay reports the properties of propranolol (lipophilic ÃŽ ²1-selective blocker) and atenolol (hydrophilic ÃŽ ²1-selective blocker) in the point of view of pharmacology, pharmacokinetics, and physical chemistry. It is observed that their pharmacological and pharmacokinetic properties are different, but its physicochemical properties are relative close. Introduction to ÃŽ ²-blockers The ÃŽ ²-blockers are drugs which act by blocking the effect of mediators and agonists on the relevant receptors. The ÃŽ ²-blockers show an antihypertensive effect, which is caused by reduced cardiac output, decreased release of renin, central decrease of sympathetic action. Also, they exhibit an antianginal effect, which is caused by slowing of the heart rate and thus decreased metabolic demand. The main side effects of general ÃŽ ²-blockers are cardiac failure, such as cardiac depression, hypotension, sinus node dysfunction, atrioventricular block. The side effects depend on the properties of ÃŽ ²-blockers. For instance, non-selective ÃŽ ²-blockers show the unwanted effects caused by blocking ÃŽ ²2-receptor. These show bronchoconstriction which is potentially life-threatening in asthmatic patients and clinically undesirable in patients with other respiratory problems. Lipophilic ÃŽ ²-blockers may cause psychological symptoms, such as depression. There are some important factors in the selection of ÃŽ ²-blockers, which are ISA, MSA, ÃŽ ²1-selectivity, lipophilicity, solubility, and the duration of effects. The ÃŽ ²2-selective blockers are not used clinically, because of causing bronchoconstriction. Some ÃŽ ²-blockers show the effect of not only blocking the receptors, but also stimulating ÃŽ ²-receptors. It depends on the situation whether ISA positive ÃŽ ²-blockers stimulate or block ÃŽ ²-receptors. For example, these act as ÃŽ ²-blockers under the existence of ÃŽ ²-agonists. On the other hand, these invigorate the receptors under the non-existence of ÃŽ ²-agonists. Such an effect is termed ISA which is intrinsic sympathomimetic activity. The drugs which have ISA decrease the side effects caused by ÃŽ ²-blockers. The non-selective blocks of ÃŽ ²-receptors cause the increase in cardiac afterload and bronchocostriction, because of ÃŽ ²2-blocking. The ÃŽ ²1-selective drugs slightly have the effect of ÃŽ ²2-blocking, but the ris k of causing cardiac afterload and bronchoconstriction is lower than that of non-selective ÃŽ ²-blockers. The duration of effects depends on the disease. Long acting ÃŽ ²-blockers are desirable for hypertension and heart failure, because of the low frequency of administration. In contrast, short acting ÃŽ ²-blockers, propranolol, are ideal drugs for angina, because of the fast onset of action. As I stated above, lipophilic ÃŽ ²-blockers have a risk of causing depression. The reason is such drugs are absorbed easily, so can penetrate BBB. MSA, membrane stabilising activity, is an activity which prevents sodium ions from entering inside of cells. Many ÃŽ ²-blockers, such as propranolol, have the activity, so these are useful for arrhythmia. The properties of propranolol Propranolol is a non-selective ÃŽ ²-blocker, which is clinically used as propranolol hydrochloride. The IUPAC name is (2RS)-1-(1-Methylethyl) amino-3-(naphthalen-1-yloxy) propan-2-ol monohydrochlorid. The molecular weight is 295.80, and the melting point is around 165 degrees. It is white crystalline powder, and it is easy to dissolve in water and methanol. Also, the methanol solution doesnt exhibit optical activity. Its structural formula is following. Propranolol is absorbed from the gastrointestinal tract, its plasma level reach a peak, 42.9ng/ml, after 1.5 hours of administration. The half life is approximately 3.9 hours. The metabolism of propranolol is mainly conducted by the liver, so it is metabolised to naphthoxylactic acid, glucuronic acid conjugate, and 4-Hydroxypropranolol. It is mainly metabolised by CYP2D6, CYP1A2, and CYP2C19. As I discussed above, propranolol can penetrate BBB and transition to the brain, because of lipophilic. Its dosage amount is mostly excreted in urine within 48 hours, and the rest is excreted in faeces, which is just less than 4 percentages. Its pharmacological actions include an antihypertensive effect, an antianginal effect, and MSA. Propranolol doesnt show ISA in the experiment with using rats, so it is considered that propranolol doesnt show human ISA as well as rats. Some side effects have been reported, such as, bronchoconstriction, slowing of heart rate, and allergic. These days, a new si de effect is becoming popular, which is mental symptoms, such as depression, nightmare, and insomnia. There is the drug-drug interaction in propranol. For instance, propranolol cant use with thioridazine which is a psychotropic drug, especially for integration dysfunction symptom. The reason is the side effect of thioridazine is likely to happen, because of preventing propranolol from being metabolised thioridazine by enzymes in the liver. In the same way, propranolol cant use with rizatriptan which is a drug for migraine. Combination use with propranolol and rizatoriptan induce the extension of half life of and the increase of AUC, so increase the side effects. Also, it is essential to avoid administering rizatoriptan within 24 hours of administration of propranolol for the same reason. Its package leaflet approved by US Food and Drug Administration warns. Therefore, its administration should not be stopped suddenly. Above statement is one of the most important warnings in the usage of propranolol. Properties of atenolol Atenolol is a ÃŽ ²1-selective blocker without showing MSA and ISA, which is used for hypertension, angina, and cardiac dysrhythmias. It is sold as TENORMIN in the market. The IUPAC name is 2-(4-{(2RS)-2-Hydroxy-3-[(1-methylethyl) amino] propyloxy} phenyl) acetamide. The molecular weight is 266.34, and the melting point is around 155 degrees. It is white or light yellow crystalline powder, and it is easy to dissolve in water and methanol as well as propranolol. In addition, the methanol solution doesnt exhibit optical activity. Its structural formula is following. Atenolol is almost half absorbed from gastrointestinal tract, and the rest enter systemic circulation without getting first pass effect on the liver. Its half life is approximately 7 hours. Atenolol is little metabolised in the liver, but some are metabolised to glucuronic acid conjugate. The data shows that atenolol is low distribution to brain compared to proranolol, because its drug is hydrophilic. Therefore, it has been reported that atenolol hardly have an influence on mental symptom unlike propranolol. The excretion of oral atenolol is approximately 50% in urine and faeces respectively, but 90% of them are not metabolised. As I stated above, atenolol is a ÃŽ ²1-selective blocker, so it is little to affect bronchial tubes which is controlled by ÃŽ ²2-receptor. However, the data have been reported atenolol inhibit ÃŽ ²2-receptor at high dose. Its side effects are almost the same as propranolol. The main difference between atenolol and propranolol is the incidence of tracheal symp toms, such as bronchoconstriction and bronchial spasm. Propranolol blocks ÃŽ ²-receptors non- selectively, so causes different tracheal symptoms. In contrast, atenolol inhibits ÃŽ ²1-receptors selectively, so barely makes such symptoms happen. The sudden cessation of therapy with atenolol has a possibility of causing cardiac diseases for specific patients. Its leaflet approved by FDA cautions, The properties of ÃŽ ²-blockers in obese patients These days, the number of obese people is increasing due to high calorie foods and the decrease of exercise. It is common for obese patients to take drug therapy in clinical practice, because obesity is connected with many diseases, such as diabetes and cardiovascular disease. Therefore, it is important to identify pharmacological and pharmacokinetic properties in obese patients. Jerzy Wojcickia studied the pharmacological and pharmacodynamic properties between propranolol and atenolol in obese patients. As a result, he concluded following. Conclusion In summary, there are some differences between propranolol and atenolol from the point of view of pharmacology, because of the difference of selectivity of ÃŽ ²-receptor. In the same way, there are some pharmacokinetic differences as well, such as the duration of half life and the mechanism of metabolism and excretion. In contrast, their physicochemical properties are similar. In clinical use, there are some warnings respectively, and the common cautions are to avoid sudden discontinuation of administration. Its dosage should be progressively decreased over a few weeks in order to avoid such side effects. I studied the characters between these ÃŽ ²-blockers in obese patients. In the study, it was not observed there are the obvious differences between obese patients and non-obese patients

Euthanasia Essay - The Need for Physician Assisted Suicide :: Free Euthanasia Essay

The Need for Physician Assisted Suicide Man is born with death in his hand. We all will die. We may be able to postpone death but we cannot avoid it. We all die of something, somewhere, somehow. Although we cannot avoid death, we can control the death caused by a terminal illness. We can determine how, when, where, and with whom we die. Right now at this time, there are over 10,000 patients in the United States that are in a permanent vegetative state. Also there are thousands of handicapped infants born each year. With the technology we have today, we are able to help people survive for long periods. About two million Americans die every year. About 85% of them are in an institution. 80% involve a decision by someone to try to prolong life or to let it go. It is estimated that around four of every five Americans will die of lingering, chronic illness, which cannot be cured but can be artificially prolonged. Odds are not in your favor to die naturally at home. The following are some thing to clear up any confusion about assisted suicide and euthanasia. Euthanasia is act of mercifully ending the life of a hopelessly suffering patient; taken from a similar Greek word meaning "easy or good death" Physician-Assisted Suicide - assisted by a qualified medical practitioner in fulfilling the wishes of a competent, terminally-ill patient to end his/her own life, usually by means of lethal injections. The difference between the two is during euthanasia is when death itself occurs, it's carried out by the doctor but in doctor-assisted suicides, the patient fulfills the final step of terminating his/her own life. "Passive" Euthanasia is ending a patient's life by withholding or withdrawing life-sustaining treatments, and "Active" Euthanasia is causing a virtually painless death by means without which life would continue naturally, usually referring to lethal injections and lastly, suicide is the act of taking one's own life voluntarily and intentionally. A very well talked about doctor who assists in suicide is Dr. Jack Kevorkian. He has pointed out the benefits of assisted suicide. Some of those are that it reduces patient's suffering family and friends of patient. Dr. Kevorkian also asks his own patients to donate vital organs or undergo a critical medical experiment, which helps science, medicine, society, and the lives of others.

The Collapse of Somalia and Economic Considerations Essay -- Essays P

The Collapse of Somalia and Economic Considerations By African standards, Somalia is a homogenous state made up of a single ethnicity, religion and culture. This led to a relatively peaceful history until Somalia was colonized by the British, French, and Italians in the 19th century. However, Somalia’s single ethnicity is broken into different clans, and sub-clans and this region’s lack of natural resources led to a fracturing of society, violence, and eventually civil war at the end of the 20th century. Despite the deterioration of society and state throughout the 70s and 80s informal black-markets (referred to as the â€Å"shadow economy†) formed to provide goods and services to the masses living under a government incapable of providing anything. This shadow economy thrived throughout the 1980s for minority elites able to participate in its transactions. Even though there was no government after President Siad Barre was deposed in 1991, the shadow economy of the 1970s and 80s was already in place, and though it didn’t necessarily distribute goods and services equitably, it did create markets and opportunities for Somalis in the 1990s. This essay will look at how: (1) colonialism and the Cold War created a relationship of Somali dependence on foreign aid; (2) the vulnerability of Somalia’s undiversified economy; (3) domestic economic policy failures and â€Å"land-grabbing† by elites; (4) the failure of IMF-World bank structural adjustment programs. The combination of these events, coupled with famine, led to fighting between warlords and the collapse of state. Finally, this essay will analyze how the process of Somalia’s decline necessitated the establishment of a shadow economy that continued to prosper despite the absence of s... ...omalia_body.html ___________________ Besteman, Catherine, Unraveling Somalia: Race, Violence, and the Legacy of Slavery (Philadelphia: University of Penslyvania Press, 1999) Besteman, Catherine and Lee V. Cassanelli, The Struggle for Land in Southern Somalia: The War Behind the War (London: Haan Publishing, 1996) Chazen, Naomi and Donald Rothchild, â€Å"The Political Repercussions of Economic Malaise,† in Hemmed In: Responses to Africa’s Economic Decline, by Thomas M. Callaghy and John Ravenhill, editors. Columbia International Affairs Online – http://www.ciaonet.org/book/callagy/chap5.html Hashim, Alice Bettis, The Fallen State: Dissonance, Dictatorship and Death in Somalia (New York: University Press of America, Inc., 1997) Samatar, Ahmed I., The Somali Challenge: From Catastrophe to Renewal? (Boulder, CO: Lynne Rienner Publishers, 1994)

The Internet :: essays research papers fc

What is the Internet? The question is actually difficult to answer, because the answer is continually changing with time. About a decade ago, the Internet would have been, â€Å"All networks, using the IP protocol, that collaborate to form a seamless network for their collective users.† But more recently the Internet itself consists of thousands of independent networks at academic institutions, military installations, government agencies, commercial enterprises, and other organizations. (Long, 197)   Ã‚  Ã‚  Ã‚  Ã‚  When one gets on the Internet they are exposed to everything the Internet can give them. They can chat with people from all over the world, view the thousands of files, and send electronic mail. The possibilities of the Internet are endless. The Internet was first started as a U.S. Defense Department network called the ARPAnet. The ARPAnet was an experimental network designed to support military research. In particular, research about how to build networks that could withstand partial outages and still function. Say in a nuclear war, if one part of the network was to be disabled, the network would still be operational. (Krol, 11) To send a message across the ARPAnet, a computer only had to put its data in an envelope, called an Internet Protocol packet or IP, and address the packets correctly. The communicating computers –not the network itself-were also given the responsibility to ensure that the communication was accomplished. The philosophy was that every computer on the network could talk, as a peer, with any other computer. (Krol, 11) In 1971, the ARPAnet included more than 20 sites. Ten years later in 1981, more than 200 sites were linked. (Krol 11) After a couple of years passed, ARPAnet had grown so much that they needed to make rules to govern the ever-growing network. The rules were called the standard protocol, and would allow communication between dissimilar computers and networks. As time went on the networks gradually adapted to each other and fused together to form the Internet. And because of this the ARPAnet was no longer needed, and ceased to exist. (Long, 198)   Ã‚  Ã‚  Ã‚  Ã‚  How does the Internet work? The Internet is built around the concept of â€Å"layers of service.† This level consists of wires and hardware, and not always very good wires. Then you add a layer of basic software to shield yourself from the problems of hardware. You add, yet, another layer of software to give the basic software some desirable features. You continue to add functionality and smarts to the network, one layer at a time, until you have something that is useful.

Presenting for Success Quotes

â€Å"Life’s like a movie, write your own ending Keep believing, keep pretending We’ve done just what we’ve set out to do Thanks to the lovers, the dreamers, and you. † – Kermit the frog â€Å"There are two types of people – those who come into a room and say, ‘Well, here I am! ’ and those who come in and say, ‘Ah, there you are. ’† – Frederick Collin â€Å"The greatest power ever bestowed upon mankind is the power of choice. Choose to persist without exception. Hold fast to your dreams and stay the course, even in the face of exhaustion, rejection, and uncertainty. † – Andy Andrews Twenty years from now you will be more disappointed by the things you didn't do than by the ones you did do. So throw off the bowlines. Sail away from the safe harbor. Catch the trade winds in your sails. Explore. Dream. Discover. † -Mark Twain â€Å"People often say that motivation doesn't last. Well, n either does bathing.That's why we recommend it daily! † – Zig Ziglar â€Å"A positive attitude won’t help you do anything, but it will help you do everything better than negative thinking. † – Zig Ziglar â€Å"We are what we repeatedly do. Excellence, therefore, is not an act but a habit. – Aristotle â€Å"Knowing is not enough; we must apply. Willing is not enough; we must do. † – Johann Wolfgang von Goethe â€Å"You gain strength, courage and confidence by every experience in which you really stop to look fear in the face†¦ You must do the thing you think you cannot do. † – Eleanor Roosevelt Nothing in this world can take the place of persistence. Talent will not; nothing is more common than unsuccessful people with talent. Genius will not; unrewarded genius is almost a proverb. Education will not; the world is full of educated derelicts. Calvin Coolidge May we never let the things we can’t have, or don’t have, or shouldn’t have, spoil our enjoyment of the things we do have and can have. As we value our happiness, let us not forget it, for one of the greatest lessons in life is learning to be happy without the things we cannot or should not have. – Richard L. Evans Did you ever see an unhappy horse? Did you ever see bird that had the blues? One reason why birds and horses are not unhappy is because they are not trying to impress other birds and horses. – Dale CarnegieWhen one door of happiness closes, another opens; but often we look so long at the closed door that we do not see the one that has been opened for us. – Helen Keller There are three types of people in this world: those who make things happen, those who watch things happen and those who wonder what happened. We all have a choice. You can decide which type of person you want to be. I have always chosen to be in the first group. – Mary Kay Ash I think there is something, more important than believing: Action! The world is full of dreamers, there aren't enough who will move ahead and begin to take concrete steps to actualize their vision. W. Clement Stone What this power is I cannot say; all I know is that it exists and it becomes available only when a man is in that state of mind in which he knows exactly what he wants and is fully determined not to quit until he finds it. – Alexander Graham Bell A man can be as great as he wants to be. If you believe in yourself and have the courage, the determination, the dedication, the competitive drive and if you are willing to sacrifice the little things in life and pay the price for the things that are worthwhile, it can be done. – Vince Lombardi You've got o sing like you don't need the money, love like you'll never get hurt. You've got to dance like no one is watching. It's gotta come from the heart, if you want it to work. – Susannah Clark Don't say you don't have enough time. You have exac tly the same number of hours per day that were given to Helen Keller, Michaelangelo, Mother Teresa, Leonardo da Vinci, Thomas Jefferson, and Albert Einstein. – H. Jackson Brown If you want to get somewhere you have to know where you want to go and how to get there. Then never, never, never give up. – Norman Vincent PealeFor many people, an excuse is better than an achievement because an achievement, no matter how great, leaves you having to prove yourself again in the future but an excuse can last for life. – Eric Hoffer If I were asked to give what I consider the single most useful bit of advice for all humanity, it would be this: Expect trouble as an inevitable part of life, and when it comes, hold your head high. Look it squarely in the eye, and say, â€Å"I will be bigger than you. You cannot defeat me. – Ann Landers Crystallize your goals. Make a plan for achieving them and set yourself a deadline.Then, with supreme confidence, determination and dis regard for obstacles and other people's criticisms, carry out your plan. – Paul Meyer Goals help focus you on areas in both your personal and professional life that are important and meaningful, rather than being guided by what other people want you to be, do, or accomplish. – Catherine Pulsifer Success is waking up in the morning, whoever you are, wherever you are, however old or young, and bounding out of bed because there's something out there you love to do, that you believe in, that you're good at — something that's bigger than you are, and you can hardly wait to get at it again today. Whit Hobbs Somehow I can't believe that there are any heights that can't be scaled by someone who knows the secrets of making dreams come true. This special secret – curiosity, confidence, courage, and constancy, and the greatest of all is confidence. When you believe in a thing, believe in it all the way, implicitly and unquestionable. – Walt Disney I believe l ife is constantly testing us for our level of commitment, and life's greatest rewards are reserved for those who demonstrate a never-ending commitment to act until they achieve. This level of resolve can move mountains, but it must be constant and consistent. – Tony Robbins

Personalities behind the civil rights movement

The Civil Rights Movement was primarily due to discrimination and racism against the African-Americans. It aimed at granting full civil and political rights and equality to all the Americans, regardless of race. This article looks into the earlier phase (1896-1954) of the many movements which constitute the Civil Rights Movements. The Civil Rights Movement would be nothing without the contributions of brave men and women towards the achievement of equal rights. These personalities and leaders made it possible to end slavery, segregation and unfair treatment to the oppressed. Even some of these people were victims themselves who struggled for freedom and justice. These leaders include: Mary McLeod Bethune, John Brown, Linda Brown, Ruby Bridges, Frederick Douglass, Medgar Evers, Marcus Garvey, Jesse Jackson, John F. Kennedy, Martin Luther King, Jr., Abraham Lincoln, Rosa Parks, Homer Plessy, Dred Scott, Sojourner Truth, Nat Turner, Harrit Tubman and Malcolm X. Every one of these leaders has his/her own story to tell, own act of selflessness in order to see the better of the country. Bethune was an African American who became an advisor of the late Franklin D. Roosevelt and created an all black school so that black children can study to have good jobs later on and vote wisely; Brown helped in preventing Kansas from being a slave state and helped slaves in escaping from their captors; Linda Brown became famous for fighting the Board of Education of Topeka to help give all black children a good education; Bridges helped in ending segregation in her school. Douglass, once a slave, helped children to read and write and fought for freedom through the speeches he gave; Evers also fought for equality for the blacks in Mississippi; Garvey started the Back to America Movement, meant to help blacks me treated right; Jackson, one of the greatest Civil Rights leader, was the second black American to run for presidency, which he believed was a key to getting more political power for the blacks; and Lincoln played a big role by issuing the Emancipation Proclamation, which was a declaration of freedom for all slaves. These were just some of those who have great contributions during the Civil Rights Movement. Their primary goal, among others, was to see that every American has equal rights regardless of race or color. To do this, not just whites but blacks must be allowed to have education or to go to an all-whites school. This was important for the blacks because it is one ticket to a good job and future. Achieving this also shows equality in education between blacks and whites. The leaders also fought for the eradication of poverty among the blacks. During those times, their only purpose was being slaves to richer people in their own state. They have no right for freedom, for good jobs around the neighborhood, and for all the good things whites enjoy. The leaders have wanted economic independence for all. Another thing they saw worth fighting for was their right to vote. Many black persons were killed brutally just for encouraging blacks to vote. The whites see this as an insult to them because they think that the blacks have no business dealing with political activities. These leaders also wanted privileges be granted to blacks, especially when it comes to the places where blacks and whites are separated, such as the seating in the buses, bathrooms, housing and school. All these goals constitute social change. The leaders wanted to end the hardships that blacks shouldered everyday. They have also longed for freedom of speech. John F. Kennedy, Martin Luther King, Jr. and Rosa Parks can be considered great leaders during these times. Their contributions have made many changes in the way blacks were treated in different states. Kennedy was the only president to appoint blacks in different federal positions as a way to end racial discrimination. He issued the Civil Rights Act of 1964 to make way for equal treatments and rights. This act abolished the discrimination on buses. Whites and blacks alike can now sit wherever they want to. It abolished discrimination in housing. Before, blacks lived in the seedier parts of town. Only whites have the right to clean, better and richer areas. Kennedy’s Executive Order # 11063 ended this. The act also abolished discrimination in voting and education. King, on the other hand, also played an important role during the Civil Rights Movement. He believed in peaceful demonstrations and rallies, protests and marches to fight against Jim Crow Laws, which segregate blacks and whites. He wanted blacks to enjoy the same privileges as the whites such as voting. His leadership brought about changes and the Jim Crow was defeated. Blacks were able to enjoy the things that used to be denied them. Lastly, Parks became instrumental in sparking the Civil Rights Movement. She was arrested one night for refusing to give the seat to a white passenger in the bus. She was found guilty, and had to pay a fine. Although she lost the case, her arrest made way for the Montgomery Bus Boycott which lasted a year. Her lawyers then filed suit against the segregation, saying it was unconstitutional. This effort was not wasted when the U.S. Supreme Court agreed with Parks’ lawyers. The segregation on the buses was finally over. REFERENCE Payne, Charles M. (1995). I’ve Got the Light of Freedom: The Organizing Tradition and the Mississippi Freedom Struggle. Berkeley: University of California Press.

Understanding Inclusive Learning and Teaching in Lifelong Learning

Form 2Assessment front sheet and feedback record PTLLS Level 3/4 Unit No:| | Learner name:| | Enrolment number:| | Date issued:| | Date submitted:| | I confirm that the evidence for this unit is authentic and a true representation of my own work. Learner signature:| | Date:| | Feedback: Continue on a separate sheet if necessary, see overleaf Tutor/Assessor/Marker and IQA’s signatures (IQA if sampled) must appear on the following page. Learners do not complete this box| Feedback: Continued from previous page) | Marker/Tutor/Assessor name:| | Grade| | Date| | Resubmission date (if referred):| | Grade| | Date| | IQA’s name (if sampled)| | | Date| | Understanding inclusive learning and teaching in lifelong learning I have delivered a teaching session covering for a colleague on sick leave. It was the first time I had worked with the group within which there was an ESOL learner, a learner with dyslexia, a learner who receives learning support and a learner with disruptive te ndencies.I am writing a journal entry for my professional development file which is presented according to the stages of the teaching cycle (See: Figure 1A The teaching cycle, Wilson, 2008, p15). This text is an analysis of the learning and teaching strategies used with an evaluation of the effectiveness of your approaches to learning and teaching in meeting the needs of learners. Also, this text is an analysis of how I selected resources to meet the needs of learners with an explanation of how I created assessment opportunities that met the needs of learners.It has been a great challenge to deliver a unique teaching session to these learners for the first time. To ensure teaching to be effective, I have followed the teaching cycle mentioned earlier as follows: the Identify need stage; the Design stage; the Implement stage and the Evaluation stage. * The Identify need stage: Before the session day, I have gathered as much information as accessible, related to the all group of learne rs (i. e. umber of students, general behaviour of the group, etc. ), the programme’s progression (In this instance, based on an existing standardisation I have found out what had been taught previously and what I had had to teach. ). During the session, I started by introducing myself to the group with an explanation of the reasons why I was standing in front of them. This enabled the learners to acknowledge me as their teacher and get ready for the session.Then, I did a diagnostic assessment through an ice-breaker to ascertain the learners had prior knowledge of the subject to be taken, to identify their preferred learning styles, to let them to choose a colour (The colour was used as font for a power point presentation and prints on pastry paper to help the dyslexic learner. ) and to enable them introduce each other. I skipped the information, advice and guidance (IAG) procedures because the course is standardised and the group has attended few sessions with my colleague in the past. The Design stage This stage was important because â€Å"To fail to plan is to plan to fail† (Petty 2004: 422). I did not need to create a scheme of work because my colleague was expected to return back to teach the next sessions. I prepared a session plan to reflect how I would create an inclusive teaching session. I created hand-outs (In this instance, I used on side of coloured pastel paper to suit the dyslexic learner) and power-point presentation which promote all aspects of society, equality and diversity.I had a contingency plan in case anything has gone wrong. Having taken into account the fact that their learning needs, learning styles and learning goals were quite different, I planned for a differentiated delivery to address individual differences. I included small group work to suit kinaesthetic learners and weak learners (In this instance it is about the ESOL learner and the learner who receives learning support), discussion to suit auditory learners and simulation to suit visual learners. * The Implement stageAfter discussion with the learners, we agreed and established ground rules to promote good behaviour and respect for everyone in the group. Soon after the ice-breaker activity, I used another activity to negotiate with the learners, ground rules which banned disruptive tendencies expressively. Each rule of the ground rules was written by one learner on a single A4 paper visible during the session. Like the other learners of the group, the learner with disruptive tendencies felt included with the opportunity to take ownership, then, followed the rules.I avoided favouritism and positive discrimination. I ensured to comply with the Equality Act (2010) and to include all learners in the session. The ESOL learner was allocated extra time to complete tasks. The learner who receives learning support had the opportunity to work collectively with other learners of the group. To meet the needs of the dyslexic learner, the chosen colour of the group was used on hand-outs and as the power-point slides’ font.

Conflicts Are Important Worksheet Essay

In this assignment, you must write 300 to 450 words on conflict and conflict management. Record your answers in this worksheet. Part 1: The Five Conflict Types Describe each of the five conflict types using paragraph form. 1. Pseudo conflicts: Pseudo conflicts are imaginary conflicts that are a result of faulty assumptions and false dilemmas (Cheesebro, O’Conner, & Rios, 2010). Many times pseudo conflicts involve two parties with the same views on a subject arguing because they misunderstand or misperceive what the other person is trying to say. 2. Fact conflicts: Fact conflicts arise when two parties disagree about information that can be easily verified or the way it is verified (Cheesebro, O’Conner, & Rios, 2010). 3. Ego conflicts: Ego conflicts usually center on status or power and occur when one party feels as though their opinion or way of doing things is far superior than anyone else (Cheesebro, O’Conner, & Rios, 2010). 4. Value conflicts: Value conflicts usually occur in personal relationships, and arise when someone challenges another’s personal beliefs in which they hold near and dear (Cheesebro, O’Conner, & Rios, 2010). These conflicts can be very intense and long lasting. 5. Need conflicts: Need conflicts arise when the needs of one individual are put before the needs of another or when the needs of each individual are not specifically stated and understood by both parties (Cheesebro, O’Conner, & Rios, 2010). Part 2: The Five Conflict Management Styles Describe each of the five conflict management styles and explain the strengths and weaknesses of each. Use paragraph form. 1. Avoiders: Avoiders steer clear of conflict and simply avoid the issues because they view it as trivial, unimportant, or have no chance of winning the argument. Strengths of avoiding style is to prevent an immediate conflict and weakness is that the conflict will fester longer and remains superficial (Thomas & Kilmann, 2014). 2. Accommodators: Accommodators believe conflict is destructive and allow others to determine the outcome (Cheesebro, O’Conner, & Rios, 2010). The strength of using this style is when the issue is not as important to you as it is to the other party and the weakness is you can begin to feel taken advantage of (Thomas & Kilmann, 2014). 3. Forcers: Forcers believe winning is everything and employ persuasion with emotional appeals (Cheesebro, O’Conner, & Rios, 2010). This style is best used when your core values need to be defended and weakness is you receive less input and ideas from others (Thomas & Kilmann, 2014). 4. Compromisers: Compromisers believe that those involved in the conflict must be ready to give in a little to reach a solution (Cheesebro, O’Conner, & Rios, 2010). This style is best used to achieve temporary settlements to complex issues and weakness is no one really gets what they originally wanted (Thomas & Kilmann, 2014). 5. Collaborators: Collaborators believe with hard work, both parties can and will get their needs met (Cheesebro, O’Conner, & Rios, 2010). This style is best used to integrate both sets of concerns and weakness is can take longer to resolve the problem (Thomas & Kilmann, 2014). Part 3: Collaborative Communication List two methods of collaborative communication and describe how using them can help you avoid conflicts. Two methods of collaborative communication are social media/software and boards. Social software such as blogs, instant messaging and social networks like Facebook and Twitter, are a great way to allow large groups to receive the same message when they are in many different places (Greene, Crystal, 2014). The use of chalkboards have been replaced by digital or electronic whiteboards and have been used for decades as way to visually demonstrate and communicate ideas that lead to brainstorming and other group collaborations. References Cheesebro, T., O’Conner, L., & Rios, F. (2010). Chapter 7: Conflict Resolution. In Communicating in the Workplace. Pearson Education. Greene, Crystal. (2014). Collaborative Communication Tools. Retrieved from eHOW.com: http://www.ehow.com/list_6828701_collaborative-communication-tools.html Thomas, K., & Kilmann, R. (2014). Five Conflict Management Styles. Retrieved from http://www.ntc.edu/studentlifeblog/wp-content/uploads/Handout-Conflict-Management-Styles.pdf

Pros and Cons of Capitalism and Socialism Research Paper

Pros and Cons of Capitalism and Socialism - Research Paper Example Capitalism is the idea whereby the possession of capital i.e. the means of production are usually owned and determined by private individuals with little or almost no interception from the government. The entire world can be considered to be operating under the capitalist system. According to the Capitalist system a small proportion of the entire world’s population controls the resources of the world. This leads them to dictate their terms and accumulate and increase their respective wealth and fortune. Many commentators consider this to be a major flaw of Capitalism. Commentators are of the view that the working classes within the economy are negatively exploited as a result of this undue power. Exercising such undue power usually results in Monopolies within the economy and these monopolies lead to an increased benefit being gained by charging higher prices for different goods and services. Except this, there are other negative aspects of Capitalism which include discriminat ive distribution of wealth amongst the economy whereby some people are favored over others. Proponents supporting the Capitalism system consider the economic system to increase economic growth of a society (Hyman, 2010). Socialism on the other hand is a system that has increased government interception with respect to the use of capital/ resources and the income is distributed amongst the people as desired by the government. Advocates favoring socialism consider the system to be a proper distributor of wealth and income amongst the public/economy. People favoring Socialism are of the view that the system has always led to an equal allocation of responsibilities. The negative aspect of Socialism is the fact that the government intervention may lead to many different factors such as decreased growth, reduced flexibility and unclear price signals. These unclear price signals may not be good enough to perform economic calculations and predict the uncertain market trends. Socialism has a lways been pointed out for its budget-constrained attribute. This lack in budgets leads to reduced innovation and growth because of reduced incentive for the people (Hyman, 2010). Economies around the World have always been found to operate under the Socialist economic system. Those economies with a view that they are following the Capitalist economy are merely facing a delusion as there is not a single country in the current era that operates without government’s intervention. Karl Marx’s idea of socialism was to hand the power to the working class and by means of such power; the working class would be able to derive their respective pay scale. According to Karl Marx, the consciousness of the working class would only be altered by a change in their working conditions such as pay scales and for a successful implementation of a proper socialism system; the capitalist system should be over-thrown i.e. possession of resources should not be confined to a limited minority ( Hyman, 2010). Proponents around the world are of the view that the socialism view has not been properly implemented to gain proper advantages from it. On the contrary, the existing system has led to a chaos within the global economy resulting in different financial and economic issues around the globe. A documentary released by some Greek theorists suggests that the economic system wrongfully portrayed as a socialist system has led to the Greek Financial Crisis. The documentary is known as ‘

No topic Case Study Example | Topics and Well Written Essays - 250 words - 1

No topic - Case Study Example However, it is important to ensure proper management and assignment of duties to teams, otherwise, the teams will harbour more competition among members than creativity. Hence producing more frustration than facilitation spending more energy and time than it would take one person to complete the same task. Teams face a number of challenges during their time of operation. The most common problem among workers is poor communication, which can lead to project failure more so when it depends on proper communication among members of the team. Secondly, some teams may face unproductive conflicts where members of the team yell at one another and gossip hence breaking the working relationship among members. Identify common goal, develop open communication, and clarify roles and responsibility (Costa, Passos, & Bakker, 2014). Organisations should learn on how to avoid challenges or manage them as outlines in the article. One the companies should ensure that they identify a common goal of the team, develop open communication and clarify goals and responsibilities. The Coca-Cola Company sees its employees as the most valuable assets, the company’s organizes its members of staff into teams hence ensuring better performance. They are grouped into teams in their different areas of speciali sation. Torrente, P., Salanova, M., & Llorens, S. (2013). Spreading engagement: On the role of similarity in the positive contagion of team work engagement. Journal of Work and Organizational Psychology, 29,

Presentation Essay Example | Topics and Well Written Essays - 250 words

Presentation - Essay Example Several studies have also demonstrated that the development of vocabulary knowledge early in school influences reading comprehension skills later in life. Since the founding of the first school for deaf students in the U.S. in 1817, literacy has been a primary educational goal for the deaf. Many different communication approaches such as oral/auditory communication, total communication, and bilingual/bicultural communication have been used in the pursuit of this goal. Despite almost 200 years of attention, DHH students are still leaving school with language skills that are grossly underdeveloped and, in many cases, are not even achieving functional literacy. This study focuses on the research question of what serves effectively to improve deaf students’ acquisition of new reading vocabulary in the third grade. A questionnaire was designed to gather teachers’ views on the most effective approaches that enable students to achieve greater academic success in building vocabulary: oral/auditory communication, total communication, or bilingual/bicultural

Impact on management science Essay Example | Topics and Well Written Essays - 2750 words

Impact on management science - Essay Example To answer this question it is necessary to examine the nature of HRM and its role in strategic organizational development and planning. Whilst top management must always accept the need for innovation there is still the decision as to which opportunities it wishes to develop in relation to its resources and those it chooses not to pursue. An effective business strategy depends upon the successful management of opportunities and coordination of HR in order to create a competitive advantage. Taking into account that HRM is not an independent part of business, it is possible to assume that HRM is a strategic activity aimed to respond effectively to changes and business transformations. The basis strategic HRM is that every manager is given a clear idea of the results expected. The human resources function is now highly specialized and perhaps can be said to be at the centre of conflict between labour and capital. They in effect operate on the 'boundary' between the workforce and the organization. Human resource management is that part of the process of management that is concerned with the maintenance of human relationships and ensuring the physical well-being of employees so that they give the maximum contribution to efficient working. It is obviously closely related to the management process as a whole and each functional manager and supervisor applies the principles effectively. Departmental managers, by effective leadership, ensure human resources policy is adhered to and department activities are successfully carried out. Michael Armstrong (2003) proposes the following definition of HRM: " the concept of HRM could be regarded as a philosophy governing how employees should be treated in the interests of the organization. But this philosophy can be applied in many different ways and there is no single model which can be used to describe HRM (p 23)" A logical approach to the consideration of this function is to look first of all at the problem of overall company organization and manpower planning, then the operations necessary to implement the plan, that is, recruitment and selection, training and development, and wage and salary administration. Other aspects of human resource management include industrial relations and the law of employment, welfare and safety, and other employee services. The importance is that the process of HRM is extremely important and continues to advance rapidly and change becomes imperative. When an organization develops a highly committed work force, coupled with enlightened management, its self-managed multifunction teams will be able to take on the challenges of the future (Price, 2004). Driven Forces of Strategic Intent to Planning Social Change as a Driven Force of Strategic Intent in HRM Social change creates new HR policies and training needs. For example, as more people travel abroad and experience the high levels of customer service in North America and the Far East they become more demanding in their expectations for customer service at home. As a further example, in society women's right to occupy jobs at the highest levels in companies and institutions. Both these examples indicate the need for HR training, the first in customer care skills and the second in management skills for women. In this situation, training is a strategic tool of the entire organization realized

The Linguistic Acquisition Device Essay Example | Topics and Well Written Essays - 1000 words

The Linguistic Acquisition Device - Essay Example He was able to give an evident account of the case of Victor of Aveyron who showed severe difficulty in developing language skills after years of isolation in the woods where he only interacted with animals. Subsequent observed improvement in language acquisition by Victor of Aveyron and a similar case of Genie in the United States seemed to provide reliable backup towards the theories of Chomsky. In the two cases of feral children, isolation from human interaction at childhood was attributed to the slow rate of language acquisition. The film Secret of the wild child is a reflection of how one United States girl commonly known as Genie was discovered in 1970 after suffering from physical abuse over a decade of isolation. The ensuing efforts to make her learn language proved difficult to achieve and this led to the advance element of Critical Period Hypothesis. In this theory, it is emphasized that there is a period mostly from infancy to adolescence when a human being has the highest potential of gaining native language competency. Outside this time limit, a child will experience severe difficulty in learning a language. The case of Genie who was discovered having been isolated for more than the critical age was an evidence of this research finding. This theory further asserts why adults find it difficult to learn the language than children as they have exceeded the critical period. After 13 years of isolation and deprivation, the mother of Genie left her abusive husband.Her mother, grandmother and herself had gone into the Social Welfare office in Temple City, California, to learn about resources for the blind in November 1970. It is at this point that a social worker grew curious over the possibly abnormal posture of the young girl who also looked younger than her actual age. The social worker’s initial thought of autism of the girl compelled her to enquire and subsequently.

Burnout on the workplace Term Paper Example | Topics and Well Written Essays - 500 words

Burnout on the workplace - Term Paper Example It was just the result of my perceptions of the job I was doing. The very fundamental work-philosophy I learned was that a worker can work as long and hard as he wants if he is really able to enjoy the work. When I tried to with confidence and hope that I can meet what the company entrusted on me, I became physically and mentally strong and that in turn helped me overcome burnout. For my colleagues and team members, it was amazing how one who was burnout has almost turned to be one of the high-performing worker. When I successfully overcome the burnout, I could really help other six members in my team establish confidence and become strong both physically and mentally in performing their tasks as well. Stress is a mental and physical condition resulting from the perceived threat of danger. The factors leading to it may vary from organization to organization. As I observed, the main sources of the stress are:- Motivation itself is a tool to reduce employee burnout and stress. When an employee is found to have experienced burnout, the manager should, as first step, identify those jobs with the highest potential for burnout. For the manager to motivate his employees and help them find their jobs interesting, he may go for redesigning the jobs, clarifying their expectations, changing work schedules, ensuring better working condition etc. A normal reason for burnout is excessive demand of the organization, but this can be overcome by motivating employees to schedule their tasks, plan what things to be done first or which particular activity should be given priority etc. If the employee can meet the expectations, he becomes both physically and mentally stronger and then as a result becomes enthusiastic in the job he is doing. Becoming happier in the job is the right-path to free from

Volunteer Turnover of a Sporting Club Essay Example | Topics and Well Written Essays - 1500 words - 2

Volunteer Turnover of a Sporting Club - Essay Example It is evidently clear from the discussion that football has successfully outmaneuvered many other team sports, such as ice hockey, basketball or handball, and has been accepted as the number one sport with regard to media attention and audience reception worldwide. The non-profit organization makes arrangements for the conducting of sports in order to generate money for some charitable purposes. Since these sports events are not conducted with any profit motifs behind them, volunteers are invited to participate in them for the recreation of the public on the one hand, and for some noble social cause on the other. Consequently, players, spectators and staff members attend the sporting club as regular participants and generate huge donations for the club. Since the staff and workforce play most important part in the development of an organization, decline in the volunteer turnover is really startling for the CEO, who has to make quick action in respect of exploring the reasons behind t he decrease in volunteer turnover. For this purpose, he should conduct interviews from the volunteers in order to extract the reasons behind their leaving the voluntary organization. The first question included in the interview would be decline in their interest as volunteers. The main reason behind asking the very question is the exploration of the causes that drift the fresh graduates away from the organization. The answer could be low salary, less growth opportunities and low social status as well. It is therefore the graduates will feel proud and delighted to work at Microsoft Corporation, but will not demonstrate any enthusiasm while working at the Bill and Melinda Gates Foundation, though both are owned by the same person. Macionis states that the non-profit organizations provide limited growth and exposure opportunities, which are not attractive and fascinating for the youth. Another important reason behind leaving the non-profit organization is this that all staff members wo rk against almost the same positions, and there are very dismal chances of promotion and salary increase. Thirdly, the voluntary clubs require very hard efforts from the staff members in order to generate money from different contacts and sectors on the on hand, and to keep the ball of struggle rolling for the social welfare purposes on the other. Somehow, in order to retain the volunteers at the sporting club, the CEO will highlight the benefits of the welfare and development of society. He will infuse new spark of hope and courage in them by stating that they are the distinguished individuals that would bring positive changes and revolutionary alterations within their social establishment by dint of their innate talent, hard work and dedication to the noble cause. The CEO will also reveal the benefits of sports and games, which keep the society healthy, vigorous and efficient. In addition, he will encourage them by stating that they are accomplishing the Herculean task by promotin g sports and recreation on charity basis, which will earn name, fame and respect for them for the future years to come.

Types of Services Essay Example for Free

Types of Services Essay The layout, menu, inventory, food prices and decoration of the restaurant determined by the services style. The service style of a restaurant depends on personal preferences, target market and location. Fine dining offers the finest food, services and atmosphere to the customers. Many people choose fine dining for a special occasion, so food should not disappoint, either in the selection or quality. No need to have an extensive menu, but it should be interesting, and offer unique dishes that customers cannot find in any other restaurant. Good food, drinks and wine should be extremely superior to anything offered at other restaurants and wine should be paired with the desire dishes and complement to customer’s menu. Also have prix fixe or limited menu that change on weekly or daily basis which allows people to buy seasonal items. In this kind of restaurant customer service is more attentive than in casual dining. Fine dining services goes far beyond taking an order and deliver food. Also provide the other services like crumbling the table between courses, replace linen napkin, explain menu without notes. Fine dining restaurant attract the people like business man, couples, family, tourist. These specific groups are focused because these are the people who frequent other restaurants and bar in the area also they are willing to spend their money on good dining and service at a value price. Cuisine History China has a civilized history of 5,000 years and Chinese cuisine has evolved over time. Chinese Cuisine enjoys high reputation in the world due to its abundance and exquisite, delicious taste and charming appearance. The Chinese food varies from local ingredient, climate, customs and cultures, so there are widely diverse food styles and taste in local regions. Chinese cuisine is any of several styles of food originating in the regions of China, some of which have become highly popular in other parts of the world.as early as the 7th century B.C Chinese cuisine began to be separated as southern and northern cuisine. Southern dishes emphasize freshness and tenderness. Northern dishes have more fat and garlic which is offset with vinegar, due to its cold weather. Its cooking techniques, preparation, serving and appreciation of food have been developed to the highest level. Cooking has occupied an important position in Chinese culture throughout its history. Chinese culture considers cooking as â€Å"an art and a science†. Rich and poor, the Chinese people consider that delicious and nutritious food is a basic necessity. There is an old Chinese saying â€Å"Food is the first necessity of the people†. Preparation method Stir frying The most frequently used method is stir frying. this method cooks processed ingredients at high heat for short period. Edible oil is used as the heat conductor. Because of short period of time, ingredients keep their nutrition value. Stir frying meat is juicy and testy , vegetables are tender and crispy. Deep frying This method uses more edible oil than stir fry, producing crisp textured food. In this method, cut the ingredients in small pieces, soak them in seasoning for a while, coat with corn starch, then fry in hot deep oil over medium heat. Shallow frying Shallow fried dishes are rather tender inside, appearing golden or slightly burnt outside. First cut the ingredients in slice or flat pieces and rubbed with seasoning. For crispiness, ingredients coated with cornstarch. Ingredients should be fried one side first and then turn to other. Braising In this method cooks ingredients over medium heat in small amount of sauce and simmering for short time of period. Also known as Hong Shao when the sauce is based on soy sauce. Boiling This is the simplest method among all the methods. It is used for small sized and soft ingredients, mostly for the vegetable soups like egg and tomato and tofu soup. It takes shorter time than braising. Prepared ingredients placed in wok with water and seasonings when the surface of the water is agitated by bubbles. Steaming This is the special method invented in china. It is used for steaming dumplings and buns in north china. In this method, place the ingredients in a steamer basket which is placed over water in a steamer pot. Roasting Roasting is to cook the food over the open flame of charcoal or in oven. To roast food, the ingredients must be cleaned, seasoned and basted with edible oil in order to reduce the loss of moisture in the ingredients during the roasting process. Regional differences within the country â€Å"There is no single Chinese diet but a wide variety of diets across the country that varies with ethnic and geographic differences.† Chinese cuisine is divided into two distinct styles northern and southern. There is a plenty of regional diversity between southern and northern region in the country’s cuisine also plenty of customs and traditions associated with the preparing and consumption of food. Northern cuisine is characterized by its extensive use of oil but the food itself is not cloyed. Northern people believe that the use of vinegar and garlic make the food delicious and tasty. There are many northern dishes that revolve around pasta. Northern popular dishes are ravioli-dumplings, noodles, steamed stuffed buns, steamed bread and fried meat dumplings. The areas of Tientsin and Shantung are the regions that are known for making use of Northern style cooking.in north Beijing jiaozi, Peking duck, Chinese traditional dumpling. Jiaozi is filled with pork and vegetables but it can be varied by the fruits or chestnuts. In history Peking duck is served to important and wealthy during the Qing dynasty. In southern style cooking people are used to use chili papers making the food more peppery and the food in general is known to possess tenderness and freshness. It doesn’t mean that all the food prepared in south is peppery, people can choose food according to their taste. Rice dishes like rice cake, noodles and congee are very popular in southern style cooking. In south, food taste is varies according to cities like people in shanghai like to eat sweet, Wuhan people like to eat peppery taste, some people in other cities like to eat salty food. In south, Guangdong region is famous for its light flavor and cooking technique and another creation of this region is dim sum which is small bite sized appetizer food.

Mind game Essay Example for Free

Mind game Essay Interrogation is a mind game. I will set up a friendly environment where the suspect feels comfortable to gain his trust and becomes receptive to my questions. I will play with his thoughts and emotions that perhaps what he did was unintentional or a result of unavoidable circumstance. I will not directly put the blame on the suspect but will make him fully understand the moral seriousness of the crime. Furthermore, I will tell him that there is overwhelming physical evidence that would implicate him to the crime and that there are witnesses and fingerprints found in the crime scene, even if I have to make a bluff. Then I will offer him different theories to what happened, one more justifiable than the other. Whichever he chose, guilt is already admitted. Preparation is essential for a successful interrogation. First, the surrounding should be conducive without distractions and guarantees privacy. This will also give me the opportunity to analyze the body language of the suspect. I will study the case facts which will be the basis for my questionings. My knowledge about the crime can somehow persuade the suspect to tell the truth. In addition, I will also study the personal background information of both the victim and suspect, more so about the suspect’s feelings, attitudes, and values. Finally, I will resolve the details of the documentation like forms, audiotape, and videos so that the interrogation process is not disrupted. The Miranda warning has adversely affected the procedures of police work. In its report Handcuffing the Cops: Miranda’s Harmful Effects on Law Enforcement, the National Center for Policy Analysis disclosed that the warning caused a significant drop in confessions. With few confessions, police have difficulty in solving crimes. Therefore, the Supreme Court should suspend Miranda for crime prevention to be effective and detect early terrorism threats. References Cassell, P. G. (1998). Handcuffing the Cops: Miranda’s Harmful Effects on Law Enforcement. National Center for Policy Analysis. NCPA Policy Report No. 218, August 1998. ISBN #1-56808-040-9 Fleisher, W L. Gordon, N. J. (2001). Effective Interviewing and Interrogation Techniques. Academic Press, New York. 1st edition. ISBN-10: 0122603818 Inbau, F. E. , Reid, J. E. , Buckley, J. P. Jayne, B. C. (2004). Essentials of the Reid Technique: Criminal Interrogation and Confessions. Jones and Bartlett Publishers, Inc. , MA. ISBN-10: 0763727288

Pediatric Trauma Scoring System in Predicting Mortality

Pediatric Trauma Scoring System in Predicting Mortality PEDIATRIC TRAUMA SCORE AS PREDICTOR OF OUTCOME OF PATIENTS ADMITTED TO CENTRALIZED SURGICAL INTENSIVE CARE UNIT IN A GOVERNMENT TERTIARY HOSPITAL: A RETROSPECTIVE COHORT STUDY I. Justification of the Study Intensive trauma care of pediatric patients is faced with many issues such as quality of care, efficiency and cost-effectiveness. Scoring systems such as the Pediatric Trauma Score can aid in clinical decision making through objective measurement of severity of illness in relation to a particular outcome such as mortality or morbidity. In particular, scoring systems have become the standard for intensive care unit outcome and efficiency benchmarking. Furthermore, there is considerable difference between clinicians prognostication estimates. Early identification of patients with high probability of mortality can help families with difficult decisions, prevent unnecessary suffering and help direct limited resources to a more practical use. Thus, this study will investigate the use of a simple Pediatric Trauma Scoring system in predicting mortality. II. Relationships of research objectives, data substrates, operationally-defined variables and data analyses. Objective Data Substrates Operationally-defined variables Analyses To compare the outcome of patients to pediatric trauma score Pediatric trauma score sheet Pediatric Trauma Score Mortality rate per category of Pediatric Trauma Score Rate of patients with Prolonged Hospital Stay per category of Pediatric Trauma Score Relationship of outcome of patient (mortality and prolonged hospital stay) to pediatric trauma score TOPIC BACKGROUND Intensive trauma care of pediatric patients is faced with many issues such as quality of care, efficiency and cost-effectiveness.1 Quantitative observations of severity of illness in pediatric trauma using scoring systems has the potential to impact overall evaluation from baseline presentation to case endpoints.2 Scoring systems have become the standard for intensive care unit outcome and efficiency benchmarking.1 Early identification of patients with high probability of mortality can help families with difficult decisions, prevent unnecessary suffering and help direct limited resources to a more practical use.1 A Pediatric Trauma Score (PTS) was developed with grading variables commonly seen in pediatric trauma accounting for the unique physiological and anatomical nature. The PTS consists of six variables. Each variable is scored +2 for minimal or no injury, +1 for minor or potentially major injury, or -1 for major or life-threatening injury. The total score ranges from +12 to -6 with increasing severity.3 Scoring systems such as the Pediatric Trauma Score can aid in clinical decision making through objective measurement of severity of illness in relation to a particular outcome such as mortality or morbidity.4 Several studies revealed consistently the direct linear relationship between Pediatric Trauma Score and injury severity thereby confirming that P.T.S. is an effective predictor of both severity of injury and potential for mortality.5 REVIEW OF RELATED LITERATURE Most of the scoring systems are not appropriate for pediatric trauma patients. Variables such as respiratory rate, heart rate, and systolic blood pressure differ with infancy and childhood. In addition, the verbal response as used in GCS is not applicable for young children. For these reasons, Tepas and colleagues3 created the Pediatric Trauma Score (PTS). The authors stated that weight becomes a variable because pediatric patients had fewer physiologic reserve. Systolic blood pressure, patency of airway, level of consciousness, presence of wounds or fractures were variables included. 3 The presence of these injuries suggests severe energy transfer and positively correlates with concomitant visceral injury.10 Below is the Pediatric Trauma Score. Pediatric Trauma Score +2 +1 -1 Weight >20kg 10-20 kg Airway Patent Maintanable Unmaintainable Systolic B/P >90 mmHg 50-90 mmHg CNS Awake + LOC Unresponsive Fractures None Closed or suspected Multiple, closed or open Wounds None Minor Major, penetrating or burns The assessment of severity of illness as well as mortality predictive value of the Pediatric Trauma Score (P.T.S.) was evaluated in several studies with different conclusions. In a study by Tepas, three categories of patients with probability of mortality were identified. Pediatric trauma score of greater than 8 had a 0% mortality while pediatric trauma score between 0 and 8 had an increasing mortality related to their decreasing pediatric trauma score. Score of less than 0 had 100% mortality. This study documented the direct linear relationship between Pediatric Trauma Score and injury severity validating that P.T.S. is an effective predictor of both severity of injury and risk for mortality.5 Consistent with the findings of the latter, Ramenonofsky compared the evaluation of pediatric trauma patients by paramedic in the field versus the physician in the emergency room using the Pediatric Trauma Score. There was agreement between the scores of these two individuals 93.6% of the time, correlation coefficient 0.991, r2 = 0.982. The sensitivity and specificity of Pediatric Trauma Score was computed at 95.8% and 98.6%, respectively. He described Pediatric Tra uma Scoring System as a straightforward modality for assessing the severity of injury.6 Eichelberge examined the applicability of the PTS found significant correlations with survival, Injury Severity Score (ISS) and mortality. 8 On the other hand, the use of PTS as a predictor of mortality was found to be inadequate in a retrospective study by Balik. Size classification was noted to be overemphasized because of the low mortality (7.7%) in children less than 10 kg. Forty-nine of 71 surgically treated patients with intra-abdominal organ injuries had a PTS >8. The existing variables of PTS did not have equal relationships to mortality.7 Critics have also noted that the PTS suffers from scoring ambiguity leading to misinterpretation and inadequate scoring.11 Problem also arises due to a systematic bias in scoring. For example, the assessment of a patient’s consciousness can be done at the scene or on admission to the emergency department. 12 Despite exhaustive review of the literature on Pediatric Trauma Scoring, there has been no mention of the predictive value of Pediatric Trauma Scoring done on patients upon entry to an ICU. Conclusion of studies on Pediatric Trauma Score may be less generalizable due to possible variability in settings.9 RESEARCH QUESTION Among pediatric trauma patients admitted to Centralized Surgical Intensive Care Unit in Davao Regional Hospital, what is the relationship of outcome of patients to pediatric trauma score using a retrospective cohort study? SIGNIFICANCE OF THE STUDY Investigating the reliability of Pediatric Trauma Scoring system in predicting mortality and prolonged hospital stay is important. The results of this study can be a validation of earlier studies made on this scoring system as a tool in objective measurement of severity of illness as well as an intensive care unit outcome and efficiency benchmarking. OBJECTIVES To determine the pediatric trauma score of all patients and classify as to pediatric trauma score category of greater than 8, 0 to 8 and less than 0 To determine the mortality rate per pediatric trauma score category of greater than 8, 0 to 8 and less than 0 To determine the survival rate per pediatric trauma score category of greater than 8, 0 to 8 and less than 0 To determine the rate of pediatric trauma patients with prolonged hospital stay per pediatric trauma score category of greater than 8, 0 to 8 and less than 0 among surviving patients To determine the risk for mortality or prolonged hospital stay among pediatric trauma patients per pediatric trauma score category of greater than 8, 0 to 8 and less than 0 METHODOLOGY RESEARCH DESIGN A retrospective cohort study of all pediatric trauma patients admitted to Centralized Surgical Intensive Care Unit between January 1, 2013 to December 31, 2013 in Davao Regional Hospital will be conducted. SETTING This study will be conducted in Davao Regional Hospital (DRH), a tertiary hospital with 250-bed capacity, in Tagum City. The Centralized Surgical Intensive Care Unit (CENSICU) is an intensive care unit for adult and pediatric surgical patients in Davao Regional Hospital. The Department of Surgery of Davao Regional Hospital is a member of the Mindanao Integrated Surgical Residency Training Program under the Department of Health, Region XI. PARTICIPANTS All pediatric trauma patients admitted to CENSICU in Davao Regional Hospital between January 1, 2013 to December 31, 2013 will be retrospectively included in the study. INCLUSION CRITERIA All patients admitted to Centralized Surgical Intensive Care Unit due to trauma All patients aged less than 14 years old EXCLUSION CRITERIA Patients discharged against medical advice Patients transferred to another hospital OPERATIONAL DEFINITION OF TERMS Traumaan injury to any site of the body described as multiple or single (neck, thorax, abdomen or extremeties) site caused by an extrinsic, blunt or penetrating agent Pediatric trauma patients-patients aged less than 14 years old admitted due to trauma Pediatric Non-Trauma patients- patients aged less than 14 years old admitted for surgical intervention of non-trauma cause (example: intestinal obstruction due to Hirschsprungs disease, massive pleural effusion due to malignancy) Prolonged Hospital Stay-length of hospital stay is more than 14 days with or without surgical intervention DATA GATHERING All pediatric trauma patients admitted to Centralized Surgical Intensive Care Unit (CENSICU) in Davao Regional Hospital between January 1, 2013 to December 31, 2013 will be identified from the admission logbook in the CENSICU of Davao Regional Hospital. The patients will be identified using the inclusion and exclusion criteria . The list of patients will be submitted to Medical Records Section of Davao Regional Hospital for chart retrieval. The charts will be reviewed for the following data will be gathered from each patient: age in years, sex, length of hospital stay in days, weight in kilograms, systolic blood pressure in mmHg, patency of airway, loss of consciousness, presence of fractures and wounds. After calculating the Pediatric Trauma Score of each patient, the category of Pediatric Trauma Score (PTS greater than 8, PTS between 0 to 8, or PTS less than 0) can be determined. In addition, the outcome of the patient will be determined as to: Mortality With prolonged hospital stay among surviving patients MaIN OUTCOME MEASURES AND OTHER DEPENDENT VARIABLES The primary outcome is the mortality rate of admitted patients categorized per pediatric trauma score of greater than 8, pediatric trauma score of 0 to 8 and pediatric score of less than 0, respectively. The secondary outcomes are the following: Number of pediatric trauma patients categorized per pediatric trauma score of greater than 8, pediatric trauma score of 0 to 8 and pediatric score of less than 0, respectively Survival rate of admitted patients categorized per pediatric trauma score of greater than 8, pediatric trauma score of 0 to 8 and pediatric score of less than 0 Rate of surviving pediatric trauma patients with prolonged hospital stay per pediatric trauma score category of greater than 8, 0 to 8 and less than 0 INDEPENDENT VARIABLE The identified independent variables include age, sex, weight in kilograms, length of hospital stay, patency of airway, systolic blood pressure in mmHg, level of consciousness, presence of fractures and minor or major wounds. SAMPLE SIZE COMPUTATION Sample size for this study was computed using Epi Info 7 StatCalc. Calculations were based on the assumptions that: 1) the ratio of patients unexposed to the risk factor (i.e., PTS greater than 8) to patients exposed to the risk factor (i.e., PTS 8 or less) is 3; and 2) the prevalence of the outcome (i.e., death) in the unexposed group is 15%. Estimations were done in order for the study to detect an odds ratio of 5 as statistically significant. In a computation for odds ratio carried out with 5% level of significance, a sample size of 79 patients will have 80% power of rejecting the null hypothesis (no significant increase or decrease in odds ratio) if the alternative holds. DATA HANDLING AND ANALYSIS Clinical characteristics (age in years, sex, weight in grams, length of hospital stay), systolic blood pressure in mmHg, patency of airway, loss of consciousness, presence of fractures and wounds, and Pediatric Trauma scores of patients will be compared statistically. A p value will be computed to establish whether the difference in the values were significant or not. A p value The Pediatric Trauma Score of each patient will be calculated and the category of Pediatric Trauma Score (PTS greater than 8, PTS between 0 to 8, or PTS less than 0) to which the patient belongs will be determined. The total number of patients in each category will be evaluated. Outcome (mortality rate or survival rate) of each patient belonging to a particular category will be tallied and each frequency computed. Among surviving patients, length of stay will be evaluated as to prolonged (>14 days) or not prolonged. Rate of surviving patients with prolonged hospital stay will be determined. Risk of mortality as well as prolonged hospital stay among surviving patients will be expressed in odds ratios (OR) with 95% confidence interval.